Watching your kids participate in sports they enjoy is a proud part of many parents’ lives. With most activities, though, there’s inherent risk for getting hurt, which can put a damper on those memories. The American Academy of Orthopedic Surgeons reports 3.5 million children under 14 are treated for sports injuries each year, many suffering from overuse. This Injury Prevention Month (April), take note of proactive exercises and practices that will help your kid stay healthy and stay on the court, field, track, and playground.

Understand that kids are not mini-adults.

“There are injuries that happen in children that literally cannot happen in adults, because adults are done growing,” Dr. Brooke Pengel, a sports medicine physician at Rocky Mountain Hospital for Children (RMHC), says in an article from the medical center. Kids are particularly vulnerable to overuse injuries and fractures at their growth plates (areas of developing cartilage at the ends of long bones). Getting swift diagnosis and treatment post-injury is also key, as young bones heal quickly, increasing the risk of healing incorrectly.

Get a physical.

Many youth sports leagues do not require a recent doctor’s office visit to begin training, unlike most high school teams. Make sure your kid doesn’t have any undiagnosed or unresolved issues such as asthma or a history of concussions. “We feel that the medical home (primary care physician) is the best place to discuss sports participation,” Dr. Gregory Walker, a pediatric sports medicine specialist at Children’s Hospital Colorado, says. “This is especially important in the age of COVID-19 infections and risk for post-infection cardiomyopathy (a disease that makes it harder for the heart to pump blood to the rest of the body).”

Look into sports psychology.

Help your child mentally prepare for a sport or competition by talking about their goals, motivations, and work ethic; this might help you understand and handle performance pressures down the line. Dr. Walker suggests bringing up mental health with a primary care provider, or scheduling a visit with a sports psychologist to discuss sports specialization (with risks for burnout and overuse injury, more on this later). 

Ease into training, and do it early.

Get the body used to the heat, altitude, and exertion before practices and games begin. If heat is going to be a challenge, have your child dress in light-colored (for outdoor sports) and breathable clothing. Make sure they build a habit of drinking enough fluids before, during, and after exercise. The American Council on Exercise has suggested 17 to 20 ounces of water a few hours prior, eight ounces during a warm-up, seven to 10 ounces every 10 to 20 minutes during, and eight ounces no more than 30 minutes after.

Incorporate mobility and strength exercises.

These can help prevent non-contact sports injuries, such as ACL and rotator cuff tears. In general, running-related athletes could benefit from strengthening their hips and core, according to Dr. Walker. He also endorses the warmup FIFA 11+ neuromuscular skill development program that’s been developed for young soccer players and proven beneficial to athletes in other sports. For young kids, Children’s Colorado physical therapist Shane Noffsinger suggests exercises such as bear crawls (for core control), plus single leg standing and balance games with partners. The National Strength and Conditioning Association is a good resource for adolescent athletes as well.

Rest to recover and rebound.

Dr. Pengel recommends setting aside at least a few months out of the year for a child to take a break from sports. She knows convincing a young athlete to rest can be a battle, but the risk of overuse injury is evident. Nearly half of all sports injuries are a result of lacking rest, according to RMHC pediatric sports medicine physician Dr. Rachel Brewer. The onset of overuse injuries—defined as injuries to bones, growth plates, muscles, tendons, and ligaments caused by repetitive stress or microtrauma—is gradual; keep an eye out for localized pain and limited function or performance.

Dr. Walker also points out that he sees a fairly high number of stress injuries, particularly osteochondritis dissecans (OCD), which is a bone disorder believed to be caused by micro trauma to bones under a joint surface. Symptoms tend to be worsening joint pain and swelling, and diagnosis is common among kids ages 10 to 15. This doesn’t mean kids should become couch potatoes in the off-season. For most pre-adolescents, continued non-structured play that spreads the forces of impact across the growing musculoskeletal system is helpful, according to Dr. Walker. Biking and swimming are good go-tos. Adolescents might try supervised weight training programs.

Connect with the coach.

Be sure your coach has an emergency plan, knows how to reach you, and has basic CPR/first aid training (or has someone certified at practices/games). Most clubs and organizations have an emergency action plan, but it is also helpful to identify nearby hospitals or clinics should a need arise.

Got questions about your kid’s specific sport or activity?

See the STOP Sports Injuries sports specific tip sheets for activities ranging from basketball to figure skating to water polo. You’ll find information about common symptoms and diagnoses plus ideas for prevention and treatment.